This prrposal is aimed at refining psychotherapeutic techniques by focusing on clearly defined target variables and a relatively homogeneous class of patients. The objectives of this outcome study of therapy in depressed outpatients are: (a) to assess the relative effectiveness of cognitive-behavioral (C/B) therapy and chemotherapy compared to chemotherapy alone for symptom relief in depressed outpatients and (b) to assess the relative effectiveness of C/B and chemotherapy compared to chemotherapy alone for preventing or ameliorating symptomatic relapses in depressed outpatients. The philosophical and historical background for the use of these techniques to influence the content and supporting constructs of the "phenomenal" field is reviewed as part of the rationale. This proposal is an extension of pilot work at the University of Pennsylvania which suggested that C/B therapy is as efficacious as chemotherapy. The combination of chemo and psychotherapy is anticipated to be more efficacious than either single modality. Thirty adult patients with depressive neurosis will be randomly assigned to either chemotherapy or combination therapy for ten weeks. Monthly follow-up will be continued for one year following conclusion of treatment. Psychotherapeutic techniques will be specified in a "Treatment Manual" (Beck & Rush, 1975) currently under development. Each therapist will be trained prior to and supervised during the study by Dr. Rush. Tape recordings and a therapist check list will be used to assure adherence to the treatment program as outlined. Videotapes of ten therapy sessions will be developed to be used for training purposes for a later more definitive study of the modality. Data collection will be consistent with that used in the previous pilot study, thereby facilitating comparison with previous results (Rush and Beck, 1975).